Surgical instrument.



Patented Nm. 19, 12H8.

i. GRENBERGER.

SURGCAL INSTRUMENT.

APPLlcMloN FILED MAR.6.19\.'.

i formed with greater Fig. 2;

JACQUES GREENBERGER, OF NEWYORK, N. Y.

SURGICAL INSTRUMENT.

i pecication of Letters Patent.

Patented N ov. 19, 1918.

Application led March, 19,17. Serial No. 152,564.

To aZZ whom t may concern:

Be it known that I, JACQUES .GREEN- BERGER, a citizen of the UnitedStates, residing in the borough of Manhattan, city, county, and State ofNew York, have invented a certain new Instrument, of which'specification.

My invention relates to surgical instruments, and is adapted moreparticularly to an" instrument for performing operations for removalofthe tonsils, they soft palate `or other minute and readily accessibleorgans, or growths, such as adenoids and thelik'e.

The objects of my invention are minor operations to be performed in sucha manner that a minimum ofhemorrhage will occur, and by means of whichsuch hemorrhage as does occur will take place after the organs have beenremoved and the operation completed.

A further object is to provide means for placing the instrument inposition, and securing it to the part of'the organ to be am-` putatedbefore the cuttingoperation is commenced.

Another object is to provide means to facilitate the removal ,oftheorgans desired to be amputated, with a minimum expenditure of energyonthe physician, and minimizing the pain Vof the patient by enabling theoperation to be perskill and despatch than now practised.

Another obj ect is-to -provide means for the ready removal ofthe severedorgans.

These and further objects will more fully appear in thefollowing-specification and accompanying dra-wings considered together.

or separately.

I have illustrated one embodiment of my invention in the accompanyingdrawings, in which like parts are designated by similar referencecharacters, and in which?- Figure 1 is a top plan view ofan instrument iembodying ymy invention Fig. 2 is a side elevationpartly in centrallongitudinal section;

Fig. 3 isa section on the line 8-3 of Fig. l;

Eig. 4 is a section on rthe line of Fig. l;

Fig. 5 is a section .on the ilineur-'S of Fig. 6 is a section Aon theline {6l-f6 of and useful Surgical the vfollowing is a i The slide isworking in slots in the slide, and is held in part of the operating Fig.Y is Fig. 2; and

Fig. 8 is a detail sectional view of the slide accommodating a snareportion of the apparatus.

In carrying out my invention, I employ a been modified to a section onthe line 7-7 of tonsilectome which has forma base or clamp for A snaremay be detachably mounted on the clamp and movable relatively therewith;the saidsnare performing the cutting operation when desired. n

In the drawings,`A designates the modied snare, and B the baseor clampformed of a modified 'tonsilectome The base `or clamp comprises a handlel by means of which it may be supported in position. The handle carriesa base plate 2, the outer extremity 3 of which is of a spatula form witha U shaped rim 4, provided onthe inner surface with a groove or recess5; the said spatula `having an'opening 6 therein.

A slide y7 is mounted on `the face of the base plate and is lmovablerelatively thereto. guided by studs on the base Contact .with'the baseby means of a spring member 8 carried by one of the studs. The front end8a of the slide is flattened to tongue shape, and its forward edge is sorounded andshapedfso as not yto come into contact with the recess 5 atthe front of the spatula, :but is so adjusted and limited in movement bythe `action vof the spring member v8 as to prevent cutting the tonsil orother organ, but have a sufficient forward movementto securelyhold/inposition the organ upon which the operation is to be performed. The`recessy 1,5 acts as a receptacle for sthe wire 16 when `it is desiredYto adjust the same preparatory'to performing the cuttingfoperation. Therear end ofthe slide is provided with .gripping means having an openingtherein, by means of which it may be moved ,relatively to the ,baseplate.

ySecured to the base plate is a U shaped guide9, the sides ofwhichextend above the slide 7. The inner portion of each side of the,guide is provided with a groove l0.

being inclinedlrelativelyto the slide 7.- They able, asahereinafterdescribed. The rearend side of the guide is proinclined face 1l and acarrying a snare.

Y portion lo,

"Sti

of the rod is provided with a screw threaded and its forward, reducedeX- tremity is provided with the usual means foi` attaching the wireloop 16, by means of which the cutting is accomplished. rlhe rearportion of the tube 13 is slotted for a considerable portion of itslength on diametrically opposite sides, as at 1T, and iinger pieces 17aare secured to the rod 1i and project through the slots, and preventrotation of the rod. rlhe forward end of the tube is flared, as at 1S,and is provided with teeth or prongs 19.

The tube 13 is provided with trunnions 20, which are adapted to engagethe grooves 10 of the guide 9.

A. spring 21 carried by the stud lof the base plate engages the underside of the tube 13, and holds the snare in properan gular relation tothe base plate.

A nut 23 engages the threaded portion of the rod, and a thumb piece 24Cis provided at the rear end of the tube 13,Y the said thumb piece havinga threaded portion so as to permit its removal for the purpose ofenabling the removal ofthe tube 13 for cleaning or otherwise.

The operation is as follows:

rfhe slide 7 is moved to the rear until the opening 6 is disclosed. Thesnare er with the loop 16 attached to thek end of the rod le whichprojects al short distance from the forward end of the tube 13, isplaced in position between the sides of the guide 9 with the trunnions2O resting in the notches 1Q., and in line with the grooves 10. Thespring 21 will retain the tube in position.y The loop 16, by its ownflexibility,

is distended, and its forwardend vrests with-- in therecess 5.

The instrument is thenplaced in position with a tonsil, for example,projecting through the opening 6. Theslide 7 is now pushed forward andpresses the neck of the tonsil against the base of the U shaped rim i.

The thumb piece '2e is pushed forward, which moves the tube 13 so as todraw the end of the rod into the tube, closing1 the loop of the wire 16,and withdrawing it from the recess 5, and engages the neclr of thetonsil rbetween thewire and the end of the tongue 8am The tube is pushedforward until that portion of the tonsil which is to be removed, isimpaled upon the teeth or prongs 19 on the end of the tube. When thetube has reachedL this position, the trunnions 2O have traversed theentire length of the grooves 10, and the base or clamp B isautomatically released from the snare er, leaving it attached to thetonsil and in proper position to sever the saine. No blood has beenshed, and the entire operation has been plainly7 visible to theoperator, and has been per- Leeenai formed without discomfort or pain tothe patient.

lf it is desired to remove the other tonsil, the snare A is held inposition by suitable means, or by an assistant. A new snare is placed inposition on the base or clamp, and the above described operation isrepeated.

llhen both tonsils are securely heldin the snares, the nut 23 is woundup on the threads 17, the rod is withdrawn farther intothe tube, drawingthe loop 16 entirely within theV tube, and severing the tonsil whichwill remain impaled on the end of the tube by the prongs 19, so thatthere will be no danger of its dropping into the throat of the patient.The operation just described is performed with the utmost despatch,greater than now in practice, and with a corresponding benefit to thepatient.

TWhen an assistant is present, the two tonsils may be removedsimultaneously.

lVhile l have illustrated the teeth or prongs 19 as an integral part ofthe tube, they may be so constructed as to be independent thereof, andbe so arranged as to be movable relative to the tube, so that the prongswill not protrudefromthe end of i the tube unless and until desired foruse in the operation.

ln accordance with the provisions of the patent statute, l havedescribed the principlc of my invention together with the apparatuswhich sent the best embodiment thereof, but I del now consider torepre-4 sire it understood that my invention is not confined to theparticular form ofapparatus V. herein shown and described, and,therefore, f

l claim broadly .the right. to employ all equivalent instrumentalitiescoming `within the scope of the claims, and by'means of which objects ofmy invention are attained, and the new results accomplished, as hereinset forth, as itis obvious that the `particular embodiment herein shownand described is only one of many that can be employed to attain theseobject-s and accomplish these results.

Having now described my invention, what l claim and desire to secure byLetters Patent is:

1. In an article of the class described, the

combination with a base, of a snare removably secured to the base, andmeans for releasing the base from the snare.

2. ln an article of the class described, thek combination with a base,of a snare removably secured to the base,and means for automaticallyreleasing the base from the snare.

3. 1n an article of the class described, the combination with a base, ofa snare removably secured to the base, and means for releasing the basefrom-the snare, and means spring carried by for relative adjustment `ofthe base and snare.

t. In an article of the class described, the combination With a base, ofa snare removably secured to the base, and means for automaticallyreleasing the base from the snare, and means for relative adjustment ofthe base and the snare.

5. An article of the class described, hav ing a base, a slide carriedbythe base, said base having an opening therein, a guide carried by thebase, an element carried inthe guide and movable relatively loop carriedby the element, said loop surrounding the opening, means for contractingthe size of the loop, and means for automatically releasing the elementfrom the guide.

6. An article of the class described, having a base, a slide carried bythe base, said base having an opening therein, a guide .carried by thebase, an element carried in the guide and movable relatively to thebase, trunnions on the element, there being grooves in the guide forengagement of the trunnions, a loop carried by the element, said loopsurrounding the opening, means for contracting the size of the loop, andmeans for automatically releasing the element from the guide.

7. An article of the class described, having a base, a slide carried bythe base, said base having an opening therein, a guide carried by thebase, an element carried in the guide and movable relatively to thebase, a the base and engaging the element, va loop carried by theelement, said to the base, a

contracting the size of the loop, and means i'or automatically.releasing the element from the guide.A

8. An' article of the class described, hav- Copies of this patent may beobtained for ve cents each, by addressing the ing grooves in the guidefor engagement ofV the trunnions, a loop carried by the element, saidloop surrounding the opening, means for contracting the size of theloop, and means for automatically releasing the element from the guide.

9. An article ot' the class described, having a base, a slide carried bythe base, said base having an opening therein, a guide carried by thebase, an element carried in the guide and movable relatively to thebase, a loop carried by the element and resting in a recess in the base,said loop surrounding the opening, means for contracting the size of theloop, and means for automatically releasing the element from the guide.

l0. An article of the class described, having a tube, a needle movablein the base of the tube, a cutting loop carried by the needle, meansfordrawing the loop Within the bore of the tube, and teeth carried by thetube in proximity to the loop.

ll. An article of the class described, having a base, a tube secured tobut movable relatively to the base, a rod movable in the bore of thetube, a cutting loop carried by the rod, means for drawing th`e loopWithin the bore of the tube, there being teeth on the tube in proximityto the loop.

Thisk specification signed and witnessed this 21st daynof February,1917. loop surrounding-the opening, means for f I JACQUES GREENBERGER."

' l Witnesses JOSEPH HOLLAND,

CI-IAs. BARRAGH.

Commissioner of Patents,

Washington, D. C.

